They are the voice to the media, the face to local groups and the ones the public looks to when it has questions. The Public information Officer is not just someone with a good voice who can parrot the command staff.

FEMA's incident command puts the PIO as part of the on scene command team. It is not a roll taken lightly by the organization who knows quick and accurate dissemination of information saves lives and helps quell the rumor mill.

A perspective from the media can perhaps best be seen through the eyes of Todd Maisel, photojournalist and writer for the New York Daily News. Since his college days in 1981 he has been covering news in and around the Big Apple and is often the go to guy for breaking news. He admits "we can be obtrusive. It's our job but I think there is a middle ground for everything."

Maisel sees some areas that can use improvement but overall he gives good reviews to the PIO's he encounters on the job.

"In the off hours, fire and police could put in more people with authority and experience. After 6:30 or 7 pm people there often don't know what they are doing," he says. "Why do you want to know? I need to know what the story is about," Maisel says he hears from some PIO's when he is calling for information on an assignment. He also has been chastised by a few EMS crews when taking photos do to HIPPA patient confidentiality. "I tell them to just to mind their business and ignore me," he says. "They are well intentioned but I shouldn't have to tell them that."

Maisel says the situation is getting better. The public's best access to what public safety does is through the media, be the story good or bad. "The NYPD is bending over backwards to make us happy," he says.

And it's not just to be nice to the press. "The more the better. When they get out positive news, it makes the bad news not so bad."

"Timely and impartial manner," is what Paul Malool, who gives a class online through the Firefighters Support Foundation, describes how to release of information.

During serious incidents, the PIO can be dispatched and confer with the incident command. "There are times in certain when the media would like to talk to the first responder first hand only through the chain of command can the PIO can give permission to talk to the media. It must be through the chain of command" he says.

Stick with the facts, not speculation, is another piece of advice for PIO's. Another thing the PIO is responsible for is setting up the area for the media to keep the media safe. The PIO is also responsible for getting the media to the media area as well. In the same presentation Anthony Mangeri discussed the importance of message mapping.

Think of a house fire as a way to see how message mapping works. It has a title: single family dwelling, residential fire, initial suppression. Stakeholders: general public and elected representatives: Questions and concerns: Is everyone ok? Any children? Are they being helped if they are displayed? How much time did it take to respond? Are you still suppressing the fire? How many apparatus? Overarching message: includes all of that information, keep in mind that this should be no more than 27 words and each sound bite is about 9 seconds. "anything more than that is subject to being edited," Mangeri said. And he leaves with the advice we partner with the media. "preferably before an event to make sure that trust and bond is there we can give them informed and validated information."

Almost all in healthcare have concerns about HIPPA. But Memphis attorney Bob Talley says that is not the only legal concern.

"You start at the state's open record law. Look what is provided or not provided," he says. For example in his state of Tennessee, health care in the ER is not subject to open records so the PIO needs to have a release from the patient or a subpoena before releasing. "If there is no state law regarding the release of information, then look to HIPPA."

Protected Health information, or PHI, is in danger of being released "anytime you can determine who the party is." Name, Social Security number, address, sex or birthdate are enough to endanger the patient's privacy. He sees most healthcare providers are compliant. "They became very aware very quickly."

Texans have a saying "It ain't bragging if it's true." In 2013 Austin-Travis County EMS (ATCEMS) decided to redo their public information office with a mix of Texas Swagger with Southern Hospitality.

The agency is separate from the fire department and responds to 911 ambulance calls in the county of about 1.1 million people and just over 1000 square miles, be it in the middle of downtown Austin or deep in a Hill Country Park. In ten years patient transports have increased by sixty percent. They have a community medic service, state of the art life-saving equipment and an EMS bus for mass casualties. Despite all those bragging rights they felt their message and identity were getting lost.

"For two decades we had a civilian PIO. Many times our message got hijacked by other agencies," said Commander Mike Benavides, who became the agencies PIO in 2013 after 20 years in the field. "We left a void. It wasn’t the fault of any agency but our own. If we don’t have a presence, then we leave it to other public agencies to talk about patients, injuries and patient statuses. That’s our info but sans having a true PI presence, that information was filled by other authorities."

When ATCEMS decided to redo their image, they started with a uniformed presence as the voice for the agency. An early mission of the agency was to make it clear what they are to be called.

The media were calling them "Travis EMS." "Austin Ambulance." Employees were called "EMS workers" or the dreaded "ambulance drivers." The new PIO office got the media straight. They are paramedics of Austin-Travis County EMS and that is what is heard and read now almost exclusively in Austin-area media."Getting your local media trained as to who to go to for what is mildly time consuming. There is a fair turn over but once they're used to it it's easy for them and quicker for them, too," said Deputy PIO Captain Rick Rutledge."We are accessible when they need something. We are at the other end of a pager number and we will provide a Twitter feed," Benavides says. A testimony to their media response- this writer received a reply from the agency four minutes after his initial email requesting an interview.

The media were far from the only ones for whom they did training. Benevides said they began a new concept for sending out information, a concept he calls "stay in your lane." The plan was that ATCEMS would be giving patient information for breaking news that involved EMS. "When we began this venture in 2013 we attempted to take our information back to convey the EMS. We figured it would have some shock value on our public safety partners if only because for two decades they were the ones providing that info. Here it was overnight we were attempt to taking that back. It might create a little bit of a rift."

He was right.

"In various meetings we reverberated a message for people to stay in their lane. In any large-scale incident, whether it's fire or law enforcement incident, one of the first questions from the media is 'were there any injuries? Any fatalities? That is our lane. That is EMS and we should be the subject matter experts," Benavides said.

Take a major MVC. Austin Fire, Police and EMS respond. Austin Travis County EMS discusses the patients. What is their condition? Where were they transported? But if asked "were alcohol or drugs suspected to be a factor?" That's for the police to answer. What kind of fire apparatus responded? Ask the fire department. "It did not happen overnight," Benavides said. "It was a slow and arduous and painstaking

process that we continue to address to this day but on fewer occasions. We have come to a good understanding with our public safety partners of what is their lane and what is our lane and where we should remain."

The turning point began early in the morning on Red River Street, Thursday, March 13, 2014.

A motorist running from the police drove north through a barricade blocking the street closed for the "South by Southwest" music and media festival, the area's largest event. Due to its popularity, there were already medics on standby as well as journalists. "I received a call from one of the medic commanders. He called me around midnight and said 'I don’t have time to talk, Mike just turn your radio start paying attention and I'll call you back.' I did and the first I heard was all the traffic about the multiple casualties. I got up and started putting on my uniform and contacted ( deputy PIO Captain) Darren Noak and told him that I was responding and for him to monitor the radio, manage the tweets, phone, email, media pager - all the behind the scene stuff." Benavides sent out the initial Tweet that EMS was responding.

Coming on the scene was something that made international news. Two were killed at the scene, two would die later and another 21 were injured but survived. Benavides was the first PIO on scene but he estimated about 60 journalists were already there.

"I corralled them (the media )on one street corner and had an officer to guard them. We coordinated the PIOs and decided how we would cover this," he recalls.

"At first because of the nature of the event, this would be a law enforcement investigation so the police said they were going to do the press conference and wanted our information. I challenged that directive saying we have all relevant information. Each agency needs to speak with their info in the event there were follow up questions so they wouldn’t have to say 'I'll get that for you." Each agency ended up speaking for its role in the incident.

"There was a bit of pushback and there was a bit of back and forth challenges," he remembers "but we worked through it on scene and basically thereafter we haven't had those challenges near to that level and I think everyone is familiar with how we do things."

Beyond such tragedies, there is the day to day business. Deputy PIO Noak says the key is "accessibility and responsiveness," to the media and public. The agency has a Facebook page where news and public relations about the ATCEMS is posted. There is a YouTube channel that contains internal videos and links from media reports. A Twitter feed is limited to breaking news. The tweets are close to real time, almost like listening to scanner.

Being a civil service agency, the PIO also handles open records requests. The best asset of a good PIO? "Number one it is a person you trust implicitly," Benavides said. "We are subject to very sensitive information. We also handle the open records request. We could ask the chief for his emails between certain dates and we decide what gets redacted and doesn't. The chief has to trust whatever we have access to that we are not going to use it in a way that would not be detrimental to the department or the city," Benavides says. "Anything we do say or comment on is official department record there is very little room for error or false interpretation."

They also need to be able to work autonomously. "The need to be trustworthy and a true understanding of what the PIO's roll is to say as if it comes from his mouth directly. We do interviews very often but we don’t collaborate with the chief on those types of things, we don't vet the information and research it or seek approval from him unless something specific like a budget," he said.

Rutledge adds "you have to be confident in expressing what you intend to express. We have different demographics in different parts of town and we need to work in all of them," he says. But the trust comes from both ways. "You’ve got to have a good support network and it starts from the top," according to Benavides. "Without their support first and foremost you could have the best PIO but wouldn’t have any success."